Eat a healthy diet, as outlined by your health care provider

What is it?

A healthy diet is one that includes a balance of foods from all the food groups, giving you the nutrients, vitamins, and minerals needed for a healthy pregnancy. For women with gestational diabetes, such a diet also helps to keep blood sugar levels in the healthy target range.

Women with gestational diabetes have special dietary needs.Because eating a healthy diet is such an important part of a treatment plan for gestational diabetes, women should not try to create their own diets. To promote health throughout your pregnancy, it is essential that you work with your health care provider to create a plan for your healthy diet. It is also important that you follow the plan as outlined by your health care provider.

The information in this booklet is specific to women who have been diagnosed with gestational diabetes. These guidelines are not appropriate for all pregnant women.

Carbohydrates are often at the center of a healthy diet for a woman with gestational diabetes.

Carbohydrates are nutrients that come from certain foods, like grain products, fruits, and vegetables. During digestion, your body breaks down most carbohydrates into simple sugars, like glucose, which is your body's main source of energy.

Eating carbohydrates affects your blood sugar level. For instance, if you eat a small amount of carbohydrate at a meal, your blood sugar level goes up a small amount. If you eat a large amount of carbohydrate at a meal, your blood sugar level goes up a large amount.

You and your health care provider will need to find a balance between eating enough carbohydrates to get the energy and glucose you need, and limiting the carbohydrates you eat to control your blood sugar level.

There are a few things you should know about carbohydrates and your healthy diet:

Your health care provider will come up with a healthy diet for you that includes the proper amount of carbohydrates to maintain a healthy pregnancy.

Some women who have gestational diabetes may need to eat fewer carbohydrates than they did before they were pregnant, to lower their total amount of carbohydrates.

Some women with gestational diabetes may need to avoid high-sugar foods, like sweets and desserts, to keep their carbohydrate levels in line. But, even though these foods have more carbohydrates and sugars in each serving than other foods do, they can still be worked into a plan for healthy eating in most cases.

Not getting enough carbohydrates can also cause problems. So, you should only limit your carbohydrate intake if advised to do so by your health care provider.

Most women with gestational diabetes follow a meal plan to make sure they are getting the nutrients they need. Types of meal plans may include:

Carbohydrate counting—For this meal plan, you count the number of grams of carbohydrates that you eat at each meal and snack to make sure you are within a certain range, as determined by your health care provider. Your meal plan may be specific, giving you definite amounts for each meal or snack, or it may be more general, with a daily carbohydrate total. A slightly different version of this meal plan changes the grams of carbohydrates into "points." Then you have to make sure you stay within a certain range of carbohydrate points for each meal or each day.

The exchange system—The exchange system has food groups that are slightly different than the food groups in the U.S. Department of Agriculture Food Guide Pyramid: breads/starches, fruits, vegetables, proteins, milk, and fats. Each food within an exchange group has about the same amount of carbohydrate, fat, protein, and calories, but the amounts of vitamins and minerals may vary among foods within each group. To follow the plan, you count the number of items from a food group that you eat at each meal. You can "exchange" one food item in a group with another item in a group without changing your plan. For instance, you can choose one (1) meat exchange (a protein) or one (1) tofu exchange (also a protein) without changing the amount of carbohydrate or calories in your meal.

Your health care provider may also tell you to get more fiber in your diet. Fiber is the part of plant foods that your body can't digest, like skins, seeds, and bran. Because fiber slows down digestion and absorption of nutrients, it can also help to control your blood sugar level. Foods that are part of a healthy diet, like fruits, vegetables, and legumes (beans and peas), are also good sources of dietary fiber. Some foods that are high in fiber, like whole grain products, such as cereals and some breads, also help prevent constipation. (See Appendix A: High-Fiber Foods for a list of foods that contain high fiber.)

Why do I have to do it?

All pregnant women need to eat healthy diets, as laid out by their health care providers, to help them get the right nutrients, in the right amounts. When you have gestational diabetes, a healthy diet also helps to keep blood sugar in the healthy range. Following a healthy diet is one of the best ways to promote a healthy pregnancy.

How do I do it?

Women who have gestational diabetes should not try to create a healthy diet on their own. They should work closely with their health care provider to make sure they are getting proper nutrition.

This table describes the Food Groups that your health care provider will use to build your diet. He or she will tell you how many servings of each group you should have in a day.

If one of the foods that you normally eat does not appear on this table, ask your health care provider what group that food belongs to. You should also ask about the serving size, so that you know how much of that food you can eat. Every question you have is important, so don't be afraid to ask.

You might also have to include these changes in your eating habits 5 to help keep your blood sugar level under control:

Eat meals and snacks (as allowed on your meal plan) on a regular schedule throughout the day. Researchers recommend that women with gestational diabetes eat at least three small-to-medium sized meals and two-to-four snacks every day.

Eat smaller amounts of carbohydrates at each meal. Rather than eating a large amount of carbohydrate at a single meal, your health care provider may suggest that you spread out your carbohydrates throughout the day. Because eating carbohydrates directly affects your blood sugar level, eating a small amount of carbohydrate all through the day will help keep your blood sugar from rising too high after a meal.

Add a nighttime snack to your meal plan. You may need to add a snack of one-to-two servings of carbohydrate before you go to sleep to keep your blood sugar at a healthy level overnight. Some examples of healthy snacks include: a piece of fruit, a handful of pretzels, or crackers.

To give you an idea of what a meal plan for one day might look like, there is a menu sample at the back of this booklet. This sample menu is not meant to replace your health care provider's recommendations. (See Appendix B: Sample Menu for more information.)

Whole Milk, Fat-free Milk, 1% Milk, or 2% Milk—How do you decide?

Health care providers recommend that pregnant women increase the amount of milk they drink to make sure they get enough calcium. Milk is one of the best sources of calcium, and of other nutrients that help the body absorb calcium. In most cases, fat-free or low-fat milk and milk products are the best calcium options because they contain the calcium and other nutrients, without the added fat. Fat free or 1% milk are among the suggested options.

If you are lactose intolerant or you have trouble digesting milk products, many lactose-free products provide calcium and other nutrients without the milk sugar.

Following a meal plan and eating a healthy diet may seem like a lot of work at first. You might have to measure food before you eat it, or not eat certain foods while you are pregnant; you might have to count carbohydrates, servings, or exchanges. Don't give up! Sticking to your meal plan is one of the most effective ways to control gestational diabetes.

When do I do it?

Eat a healthy diet or follow a meal plan for your entire pregnancy to improve your health and to help ensure a healthy pregnancy. If you need to make changes to your diet or meal plan to keep your glucose level in the healthy range, your health care provider will help.

How do I know that I'm doing it right?

One sign that your diet or meal plan is successful is that your glucose level will usually stay within the healthy range (see the Healthy Target Range for Blood Sugar table). Talk to your health care provider about what to do if you have abnormal blood sugar numbers.